(P02-094-25) Perceived Food Environments and Healthiness of Diets Among Adolescents in Urban Bangladesh

Objectives: Adolescents' food-environment perceptions can play critical roles in their dietary behaviors and nutrition. This study explores how adolescents’ perceived food environments relate to their healthiness of diets and how these relationships differ between adolescents living in urban non-slum (AD-NSL) and slum areas (AD-SL) in Bangladesh.

Methods: A cross-sectional study was conducted among adolescents (N=330; 10-15 years old) from urban NSL and SL areas in Dhaka, Bangladesh. A pre-tested semi-structured questionnaire measured food-environment perceptions of healthy and unhealthy foods, and dietary intake was assessed using the Global Diet Quality Score (GDQS) application. Risk of nutrient inadequacy (NI) was categorized based on GDQS score (low: >23, moderate: ≥15 and < 23, high: < 15). Ordered logistic regression models examined associations between food-environment perceptions and NI risk accounting for demographic variables and moderation effect of living areas.

Results: Adolescents perceived healthy foods to be more available than unhealthy foods, but unhealthy foods to be more accessible, affordable and convenient. AD-SL had higher moderate and high risks of NI (58.3% and 65.7%, respectively) compared to AD-NSL (41.7% and 34.3%, respectively). Food-environment perceptions of healthy foods were not associated with NI risk except for desirability after accounting for demographics. Moderation by living area (OR = 0.53, p < 0.05) meant that when perceived access to healthy foods was low, AD-NSL were more likely to have poorer diets compared to AD-SL. For unhealthy foods, perceived desirability was associated with higher NI risk (p < 0.01) while perceived availability showed a negative association (p < 0.05). Living area showed no interactions for unhealthy foods.

Conclusions: Food-environment perceptions are related to adolescents’ healthiness of diets, with differences between slum and non-slum areas. Future adolescent-centered interventions considering the variations of food-environment perceptions in urban non-slum and slum areas can be designed to enhance access and desirability of healthy foods while limiting unhealthy food exposure to improve overall healthiness of adolescents’ diets.

Funding Sources: Department of Health Promotion, Education, and Behavior, University of South Carolina